Musculoskeletal - Week 10 Flashcards
You note inflammation of the prepatellar tendon in your 15 y.o. female patient. You suspect: (Pearls & Pitfalls lecture)
a. Osgood Schlatter Disease
b. Slipped Femoral Capital Epiphysis
c. Talipes equinovarus
d. Legg-Calve-Perthes
*Extra: What are exam findings for each?
A
Osgood Sclatter disease - knee pain in adolescents – inflammation of patellar tendon
slipped femora capital epiphysis - head of the femur (the ball) slips backward and down off the femur – most often in preteens and obese males
talipes equinovarus - club foot, completely turned in
leg-calve-perthes - avascular necrosis of femoral head
This image shows palpation of what area? (Bates, p. 661)
*Thumb over top part of hand above thumb joint
a. MCP
b. Anatomic snuffbox
c. Radial sheath
d. Radiocarpal joint
B
Genu varum is a term used to described knocked-knees. (Bates, p. 684)
a. True b. False
B
knock knees = genu valgum
bow-legs = genu varum
Melissa was playing soccer today & noted sharp pain in her right knee. In the office now, one of the 1st questions you ask is: (Bates, p 632)
a. Mechanism of injury b. Onset of symptoms c. Duration of symptoms d. Alleviating factors
A
An example of non-inflammatory MSK disorder is: (Bates, p 632)
a. Gout b. Rotator cuff tear c. RA d. Idiopathic
B
All are considered dynamic stabilizers of the shoulder except: (Bates, p 647)
a. Latissimus dorsi b. Supraspinatus c. Infraspinatus d. Teres minor
A
The most common cause of shoulder pain in primary care is arthritis. (Bates, p 652)
a. True b. False
B
A positive Bulge sign would indicate: (Bates, p 687)
a. Full-thickness rotator cuff tear b. Torn ACL c. Mild knee effusion d. Achilles tendon rupture
C
The 1st imagine would be used to assess the ACL & is known as ______ (Bates, p 690)
*pushing knees up and together
a. Posterior drawer b. Anterior drawer c. McMurray Test d. Valgus stress
*Extra: what is tested for each maneuver?
B
posterior drawer - PCL injury
anterior drawer - ACL tear
McMurray test - tear of medial meniscus
Valgus stress - MCL injury
The most commonly injured muscle in the rotator cuff is: (Bates, 650)
a. Supraspinatus b. Infraspinatus c. Teres minor d. Subscapularis
A
You detect proximal muscle weakness of the lower extremities (+Gower’s sign) in a toddler (depicted below). You are suspicious of: (MSK lecture)
Child having difficulty and needing to push bent legs straight to go from crawling on all fours to standing
a. Occult spina bifida b. Congenital hip dysplasia c. Tibial torsion d. Neurodegenerative disorder
- Extra: What would you see with the other disorders?
D
occult spina bifida - pigmented spots, hairy patches, or deep pits
congenital hip dysplasia - ortolani & barlow
tibial torsion - pigeon toed
neurodegenerative disorder (like muscular dystrophy)
You are testing adduction & internal rotation of your patient’s R shoulder. This image shows ________ test. (Bates, p. 653)
patient reaching behind themselves just under the scapula with back of hand
a. Crossover or crossed body b. Rotator cuff pain provocation c. Apley’s d. Internal rotation lag
- Extra: What does each test assess for?
C
crossover or crossed body - acromioclavicular joint
rotator cuff pain provocation - painful arch test. subacromial impingement/rotator cuff tendinitis
Apley’s - rotator cuff disorder or adhesive capsulitis
internal rotation lag - subscapularis disorder
You assess pigmented spots, hair tufts & deep pits on the spine base of a newborn. You know this is potentially indicates______ (Bates, p. 842)
a. Hirsutism b. Spina bifida (mengiomyelocele) c. Congenital drawfism d. Early severe scoliosis
B
The SITS muscles are supraspinatus, infraspinatus, teres minor & subspinatus. (Bates, p 647)
a. True b. False
B
SITS muscles are supraspinatus, infraspinatus, teres minor and subscapularis
On examination, your patient has a + Empty Can test. This likely indicates: (Bates, p 655)
a. Bicipital tendonitis b. ACL tear c. Supraspinatus tear d. Greater trochanter bursitis
C
Your patient presents with this exam finding. You suspect: (Bates, p 704)
one or more fingers permanently bent in a flexed position
a. Depuytren contracture b. Trigger finger c. Boutonniere deformity d. Chronic RA
A
A positive Tinel’s & Phalen’s signs would indicate: (Bates, p 664)
a. de Quervains tenosynovitis b. Dupytren contracture c. Lateral epicondylitis (tennis elbow) d. Carpal tunnel syndrome
D
You are assessing your patient’s left shoulder. You ask her to place one hand behind her back & touch her shoulder blade. This movement is an example of: (Bates, 651)
a. Adduction b. External rotation c. Internal rotation d. Abduction
C
Apley has 2 variations
1 tests abduction and external rotation - hand above head to touch opposite scapula
1 tests adduction and internal rotation - one hand behind back and touch opposite shoulder blade
Your patient is in today c/o low back pain. He tells you it is associated with urinary retention & saddle numbness (anesthesia). You are concerned there is an injury or lesion to: (Bates, p 635)
a. C1-C2 b. L1 – L2 c. L3 – L4 d. S2 – S4
D
You are assessing for low back pain. You want to rule out red flags. You know these include all except: (Bates, p 635)
a. Long-term NSAID use b. History of cancer c. Pain at night d. age 57
A
Who would be at higher risk of slipped capital femoral epiphysis (SCFE)?: (Pearls & Pitfalls lecture)
a. 32-y.o. retired soccer player b. 11-y.o. male with BMI of 28 c. 18 y.o. female gymnast d. Newborn with +Ortolani/Barlow’s
B
These pictures depict what exam technique? (Bates, p. 844)
flexing infants knees and at the hip and abducting thighs simultaneously to table
a. Adams test b. Ortalani c. Barlows d. Pes planus
*Extra: How is this performed? What is it assessing for?
B
You have a 4-month female with a negative Ortlani & Barlow test. You can confidently let the caregivers know that their child does NOT have any hip dysplasia. (Bates, p. 844) )
a. True b. False * Extra: Justify your answer
B
children older than 3 months may have negative ortolani or barlow sign and still have dislocated hip due to tightening of the thigh muscles and ligaments
all babies should receive serial hip examinations until they are walking
infants beyond 3 months, limited abduction is concerning for developmental dysplasia of the hip
You see the following on exam. You would document this as: _________ (Bates, p 922)
foot rolling outward
a. Varus (inversion of the foot) b. Matatarsus adductus c. Pes planus d. Pronation
A
The Lachman test is used to assess stability of the lateral collateral ligament: (Bates, p 690)
a. T b. F
B
it tests for ACL tear
Your patient has discomfort when their left thumb is abducted against resistance with + Tinel’s & Phalen’s signs. You know your patient likely has (Bates, p. 664):
a. de Quervains tenosynovitis
b. Carpal Tunnel Syndrome
c. Dupuytrens Contracture
d. Ulnar Nerve Compression
*Extra: What exam techniques can be utilized to assess the other disorders?
B
You note thenar atrophy on your patient’s R hand. They are also c/o paresthesias here as well. You are most suspicious for: (Bates, 660)
a. Carpal Tunnel Syndrome
b. Ulnar Nerve Compression
c. de Quervains Tenosynovitis
d. Dupuytren Contracture
*What nerve is involved with the answer? What other symptoms might your pt have? What are the symptoms of the other options?
A
You note a + Adam’s test on examination of your patient’s spine. You would diagnosis your patient with __________ based on this finding. (Bates, p. 886)
a. Slipped capital femoral epiphysis b. Tibial torsion c. Hip dysplasia d. Scoliosis
D
All are exam techniques of the shoulder except: : (Bates, p. 653)
a. Crossed body adduction test
b. Hawkins impingement
c. Abduction (Valgus) Stress Test
d. Empty can test
C
Abduction (Valgus) stress test - tests knee for MCL injury
On examination, your patient has a + Empty Can test. This likely indicates: (Bates, p 655)
a. Bicipital tendonitis b. ACL tear c. Supraspinatus tear d. Greater trochanter bursitis
C
You are performing a MSK assessment on a newborn. You know all are abnormal findings except: (Bates, p 842 – 845, 922)
a. A clavicular lump noted on palpation b. Palpation of a “clunk” when you adduct both hips simultaneously c. Twisting of the tibia inwardly on its longitudinal axis d. Inspection noting talipes equinovarus
C
You note Heberden & Bouchard nodes on your patient’s bilateral phalanges. You know these are commonly associated with rheumatoid arthritis. (Bates, p. 660)
a. True b. False
B
these nodes are found in osteoarthritis
You are conducting a MSK on a toddler. You see increased lumbar concavity & decreased thoracic convexity (compared with an adult). You explain to the caregiver that this is a concerning abnormality but readily repaired with bracing by orthopedic specialist.: (Bates, p. 885)
a. True b. False
B
The “7 structures of the knee” are: medial & lateral menisci, the LCL & MCL, the ACL & PCL and _____________. (Bates, p. 684).
a. Tibiofemoral joint
b. Medial tibial plateau
c. Tibial tuberosity
d. Patellar tendon
D
The proper term for “bow-legs” is _______ (Bates, p. 684)
a. Genu Varum b. Crepitus c. Genu anserine d. Genu vastus
A
